Everything You Need to Know About Sore Throat (Pharyngitis)

Pharyngitis, or sore throat, is the presence of inflammation in the back of the throat (also called the pharynx). (1)

One of the most common reasons for people to visit their doctor, pharyngitis can make it painful to swallow. You may experience soreness, discomfort, pain, or scratchiness in the throat.

Pharyngitis is often present because of an underlying cause, such as a cold, the flu, or mononucleosis ("mono"), each of which is caused by a virus. Most sore throats subside within a week or less. If a sore throat lasts for more than a week to 10 days, you should see your doctor. (2)

Causes of Sore Throat

Pharyngitis is caused by swelling in the pharynx, between the tonsils and the larynx.

Most sore throats occur during colder months and are caused by viral infections such as the common cold, the flu, mono, measles, chickenpox, and croup. (2)

Sore Throat With Mononucleosis

When a Sore Throat Is Chronic

Persistent throat pain that feels worse on one side may indicate a bacterial infection, which usually begins as a complication of tonsillitis or untreated strep throat (peritonsillar abscess). (5) In some cases, the pain may indicate an advanced tumor. (6)

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"A sore throat accompanied by a swollen neck gland should be seen by a physician soon," says Toribio Flores, MD, an ear, nose, and throat specialist for the Cleveland Clinic's Head and Neck Institute at Independence Family Health Center in Independence, Ohio.

Diagnosing the Cause of a Sore Throat

Diagnosing what’s causing a sore throat is key to determining how it should be treated.

Your doctor will most likely start by taking your medical history and then giving you a physical exam that may involve checking your temperature; looking at your throat, ears, and nose with a lighted instrument; checking your neck for swollen glands (lymph nodes); and listening to your breathing with a stethoscope.

Your healthcare provider may also take a throat culture or do a rapid strep test by taking a swab from your throat to be checked for the bacteria group A strep (the cause of strep throat). (7)

Some clinics can get results right away, while others need to send off the sample to a lab for testing.

If the rapid in-clinic test comes back positive, then you almost certainly have a bacterial infection (i.e., strep throat). If the test comes back negative, then you likely have a viral infection.

A blood test might be done to determine whether an infection is more likely caused by a bacterial or viral agent.

If your doctor suspects that your sore throat is related to an allergy, you may be referred to an allergist for additional tests. If you experience chronic or frequent sore throats, you may be referred to an otolaryngologist (ear, nose, and throat doctor).

Could It Be Strep Throat?

Strep throat is a bacterial infection that is common in school-age children, but it’s not the most common cause of a sore throat. Viral infections are much more common.

The Centers for Disease Control and Prevention estimates that there are several million cases of infection with group A strep bacteria in the United States each year. (8) Worldwide, strep throat affects as many as 616 million people each year. (9)

Strep throat mostly affects children ages 5 to 15, but anyone can get it. It is caused by bacteria known as Streptococcus pyogenes (group A strep). (10)

The symptoms of strep throat can overlap with signs of a viral infection. Besides sore throat, they may include fever and body aches. If you have any of these symptoms along with a runny nose or a cough, it could be viral. The only way to tell if a person has strep throat is by a throat swab. (10)

Sore Throat With a Cold or the Flu

Influenza, or the flu, and the common cold can be tricky to tell apart. Both are respiratory illnesses caused by viruses, and they share many symptoms, such as sore throat, which may be accompanied by cough, nasal congestion, sneezing, body aches, headache, and fever. (11)

Common cold symptoms typically develop about one to three days after exposure to cold-causing viruses. Flu symptoms are typically more severe than those of the common cold.

Since colds and the flu are caused by viruses, rather than bacteria, antibiotics are not an effective treatment option. There is no cure for a cold, though over-the-counter medications may ease symptoms.

Antiviral Medications for Flu-Related Sore Throat

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Antiviral medication can shorten the length of the illness and make symptoms milder. They can also reduce your risk of flu complications, which is why these drugs are often recommended for people who are at a high risk, such as children, older adults, and people with certain preexisting conditions.

Antivirals come in the form of pills, liquid medication, and inhaled medication. They prevent the virus from spreading in your body. (12)

Antibiotics for Sore Throat

If your sore throat is caused by a virus, antibiotics won't help, and it will go away on its own within five to seven days. However, antibiotics can help if your sore throat is caused by the following:

Antibiotics are not prescribed to treat strep itself but to prevent serious complications, such as rheumatic fever. (13)

Narrow-spectrum antibiotics are limited in the number of bacteria targeted by the drug and will not affect as many of the normal bacteria in the body. Guidelines from the Infectious Diseases Society of America recommend narrow-spectrum antibiotics such as penicillin. Penicillin is the treatment of choice for strep throat. (14)

Amoxicillin is considered to be a broader-spectrum antibiotic, so it will kill more bacteria than penicillin.